Anemia, Coagulopathy, Mild, Hypofibrinogenemia, Thrombocytopenia
Conditions
Keywords
Transfusion, Clinical Decision Support
Brief summary
Determine whether clinical decision support (best practice advisory) improves provider adherence to transfusion guidelines for all four major blood components (red blood cells, plasma, platelets, and cryoprecipitate) using a randomized study design to reduce risk of bias. Alerts will be visible to the experimental ordering provider group, while they will not be visible to the control. Both groups still have access to information about best practices: local clinical transfusion guidelines are available and education on blood transfusion best practices will continue regardless of randomization assignment.
Interventions
BEHAVIORALClinical Decision Support
In blood product order entry within the electronic health record, the ordering provider is required to select an indication for the blood product order. If the patient's laboratory values are not in line with the guideline indication selected, a clinical decision support alert will fire and be shown to the ordering provider. This alert will inform the provider that the order is outside institutional guidelines and the provider has the option to cancel the order (or bypass the order and select a reason for proceeding with the order).
Sponsors
University of Utah
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
HEALTH_SERVICES_RESEARCH
Masking
SINGLE (Subject)
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
\- Ordering providers that order at least one blood product in the electronic health record
Exclusion criteria
* Any individual without privileges to place an initial order for blood product(s)
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Number of blood components transfused that met clinical decision support alert criteria | Through study completion, an average of 12 months | Number of blood components transfused (includes red blood cell, platelet, plasma, and cryoprecipitate pools) that met criteria for clinical decision support alerts to fire |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Number of red blood cell components transfused that met clinical decision support alert criteria | Through study completion, an average of 12 months | Number of red blood cell components transfused that met criteria for clinical decision support alerts to fire |
| Number of platelet components transfused that met clinical decision support alert criteria | Through study completion, an average of 12 months | Number of platelet components transfused that met criteria for clinical decision support alerts to fire |
| Number of plasma components transfused that met clinical decision support alert criteria | Through study completion, an average of 12 months | Number of plasma components transfused that met criteria for clinical decision support alerts to fire |
| Number of cryoprecipitate component pools transfused that met clinical decision support alert criteria | Through study completion, an average of 12 months | Number of cryoprecipitate component pools transfused that met criteria for clinical decision support alerts to fire |
Other
| Measure | Time frame | Description |
|---|---|---|
| Number of blood components transfused | Through study completion, an average of 12 months | Number of blood components transfused (includes red blood cell, platelet, plasma, and cryoprecipitate pools) that met criteria for clinical decision support alerts to fire |
| Number of red blood cell components transfused | Through study completion, an average of 12 months | Number of red blood cell components transfused |
| Number of platelet components transfused | Through study completion, an average of 12 months | Number of platelet components transfused |
| Number of blood components ordered that met clinical decision support alert criteria | Through study completion, an average of 12 months | Number of blood components ordered (includes red blood cell, platelet, plasma, and cryoprecipitate pools) that met criteria for clinical decision support alerts to fire |
| Number of cryoprecipitate component pools transfused | Through study completion, an average of 12 months | Number of cryoprecipitate component pools transfused |
| Blood component cost difference between clinical decision support eligible transfusions by study arm | Through study completion, an average of 12 months | Blood component acquisition cost difference of completed alert eligible transfusions between study arms |
| Number of plasma components transfused | Through study completion, an average of 12 months | Number of plasma components transfused |
| Number of red blood cell components ordered that met clinical decision support alert criteria | Through study completion, an average of 12 months | Number of red blood cell components ordered that met criteria for clinical decision support alerts to fire |
| Number of platelet components ordered that met clinical decision support alert criteria | Through study completion, an average of 12 months | Number of platelet components ordered that met criteria for clinical decision support alerts to fire |
| Number of plasma components ordered that met clinical decision support alert criteria | Through study completion, an average of 12 months | Number of plasma components ordered that met criteria for clinical decision support alerts to fire |
| Number of cryoprecipitate component pools ordered that met clinical decision support alert criteria | Through study completion, an average of 12 months | Number of cryoprecipitate component pools ordered that met criteria for clinical decision support alerts to fire |
Countries
United States
Outcome results
None listed